Four Policy Ideas Towards Co-Governance

I guess the world feels a very different place right now. 

Whether you’re pro Donald Trump or anti Donald Trump, there’s a sense of change in the air that’s either hopeful or foreboding. 

But I want to step away from the cacophony of the now and stay focused on the core idea that animates my work – that the pursuit of better population health, including health equity, will only come about through true partnership between governments and people. 

It’s fashionable these days to say that those with lived experience need to lead the work. Even our Policy Insight article in Health Affairs had that assertion. But I’m not sure it’s entirely right. I think it’s better to say they need to co-lead the work. 

The job of protecting and promoting health is complicated stuff. The idea that The Average Joe will know how to do that at a population level is fanciful. But that doesn’t mean that he doesn’t have anything useful – perhaps essential – to contribute. 

So, what does that collaboration look like? 

I’ve been thinking about that as part of my work with a UK think tank that’s exploring how the new government can work in partnership with the people. For me, it’s all about community power and, as I’ve written recently, few proposed policies are clear on that, those that purport to be seem confused, but across the board there may be a tacit understanding of what power is. 

Assuming that tacit understanding is real, there are still, for me, gaps in the policies being proposed. There are two broad areas. The first is how people can be supported to develop their power. The second is how does ‘the system’ respond. 

Developing Community Power 

What I understand from practitioners and researchers is that people develop their power by being part of groups. Traditionally, these have been formal groups, such as religious institutions or trade unions. However, membership of these groups have dwindled and so communities have no formal vehicle for their views. 

However, most people are in informal groups. They could be co-workers in an industry without trade unions. They could be parents with children in the same school. They could be neighbours in a street. These informal groups are important. People have a sense of belonging to them, and it’s where their ideas are shared and shaped. 

The problem is these groups don’t have the formal structure needed to receive funding so they’re precarious. One of my policy ideas, then, is to lower the bar to receive funding so that informal groups can be supported. Also, practice and research shows that these groups have power by being in alliances with like-minded groups and so the funding also needs to be available to networks of groups. 

It remains the case, though, that those with the most time are the most likely to create groups and so there needs to be a mechanism to ensure that time-poor people are adequately supported to create groups too. My policy idea is that there be some kind of neighbourhood-level ombudsperson appointed to ensure that groups and networks are being formed by all residents, not just those with enough immediate privilege to do so. 

Changing How The System Responds 

One of the things you hear all the time is that ‘the system’ resists changing. One example I heard as part of this work was how in a genuine attempt at system-people collaboration, what the people wanted impacted multiple parts of ‘the system’ and they were just not used – and, in the end, not able – to work together. As a consequence, what the people wanted was ‘resisted’. 

I think it’s easy to blame ‘the system’ for being obstructive but it’s well-documented that system change is hard work. For me, then, the policy ideas is a first step towards better understanding the challenge – get each local government to publish an annual report on how it is trying to meet its obligations to national government with the more local demands of people. 

I hear you. Oh Lord! Not another report that no one will ever read. I agree that’s a danger but the idea is that the report informs a learning process in which system and community leaders from around the country come together to compare notes (the report), learn from each other, and take better practices back into their collaborative work. 

A few leaders I’ve interviewed as part of this work have reminded me that many people at the sharp end of society have a terrible view of government because of how bad it is to interact with ‘the system’. They get pushed around, let down, and generally disrespected. The last thing they’ll want is to collaborate with it. 

I can’t help feeling this is yet another thing we need to get a better handle of. And so, my policy proposal is to have some kind of survey of how people experience ‘the system’. It’s important for this survey to just be about the experience, not the outcome. I think we’ve all had times when we’ve got what we wanted but the experience was so awful we’re left feeling negative. It’s that feeling we have to get a handle on, and then work out how to change it. 

Grappling Towards Co-Governance 

The above four policy ideas are just suggestions. My colleagues in this work will consider them, propose their own, and, together, we’ll debate them, not just for their merit but to see if they can be packaged into a compelling narrative that the UK government can get behind. 

But, ultimately, all this talk about ‘true partnership’ and ‘collaboration’ is about co-governance – revitalising democracy to get the best from the power of government and the power of communities to improve people’s lives. If we can get that right – or right enough – perhaps we can move beyond this polarised moment of hope and foreboding. 

See you in two weeks. 

Pritpal S Tamber

The image behind the title is by Huan Tran / Ikon Images